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To lower prescription drug costs, states head to the courthouse
Last month, the Federal Trade Commission released a scathing report suggesting that pharmacy benefit managers, the middlemen in the drug supply chain known as PBMs, are “profiting by inflating drug costs and squeezing Main Street pharmacies.” The FTC found that because of consolidation in the industry, the three largest PBMs now manage nearly 80% of […]
States want to lower drug prices. A federal law stands in their way
Oliver Lackey opened a pharmacy in his hometown of Fairview, Oklahoma, so he could “provide the best patient care.” He set up shop a decade ago in the local grocery store with “zero prescriptions.” Before long, business took off — yet he was still struggling. “I was getting more patients and was filling more prescriptions,” […]
Cooler states now forced to grapple with extreme heat fueled by climate change
NEW YORK — As temperatures soared into the 90s, the heat and humidity hit the concrete in Astoria, Queens, and bounced into the air. People moved along the scorched sidewalk slowly, their clothes drenched with sweat. Elianne Alvarado, 44, who was raised in New York City and has lived here for most of her life, […]
States struggle to help patients navigate insurance hurdle known as ‘step therapy’
Cassidy Yermal, 32, began experiencing debilitating migraines when she was 17 years old. As a teenager growing up in northeastern Pennsylvania, she saw numerous neurologists and tried a variety of medications before finding one that provided relief. In 2022, her new insurer asked her to prove it. Yermal now lives in Marlboro, Maryland, where she’s […]
Amid mental health crisis, new compact allows social workers to practice across state lines
Stefani Goerlich, a certified sex therapist and social worker with a private practice in Detroit, sees several dozen clients a month, most of them from underserved and minority backgrounds. She speaks to them about sensitive matters such as gender-affirming care, and building trust takes time. Those hard-won relationships often are upended when clients move away […]
States want to make it harder for health insurers to deny care, but firms might evade enforcement
For decades, Amina Tollin struggled with mysterious, debilitating pain that radiated throughout her body. A few years ago, when a doctor finally diagnosed her with polyneuropathy, a chronic nerve condition, she had begun to use a wheelchair. The doctor prescribed a blood infusion therapy that allowed Tollin, 40, to live her life normally. That is, […]
Taxpayers were overcharged for patient meds. Then came the lawyers
In 2018, when Mike DeWine was Ohio’s attorney general, he began investigating an obscure corner of the health care industry. He believed that insurers were inflating prescription drug prices through management companies that operated as middlemen in the drug supply chain. There were concerns that these companies, known as pharmacy benefit managers, or P.B.M.s, were […]